In the US, a system has been developed to provide disaster sheltering for persons with special needs in what are now termed alternate care sites (ACS). As in many other developed countries, as the population ages, the rates of people with chronic diseases that require complex health care management in the home setting has increased. The aim of this study was to identify the key chronic diseases, conditions, and therapies that should be planned for in ACS operations.

A convenience sample (n = 402) of senior citizens (≥ 65) who resided in Honolulu, Hawaii were interviewed and completed a 15-item survey that asked about demographics, existing health conditions, activities of daily living abilities (ADL), and requirements for ongoing care.

The mean age was 68 years; 56% were female. The most common health issues included: hypertension (53.4%), heart disease (24.6%), diabetes mellitus (23.3%), and asthma (15.1%); while 11% (n = 47) reported they required daily physical assistance ADLs, including: getting up from a chair (15.1%), walking (8.1%), taking medications (8.1%), dressing (5.2%), and toileting (4.2%). Of these 47 people, most (81%) had someone who would help them in a disaster shelter, while nine (19% of the total who required assistance) had no one to help them. On average, of the respondents who reported they took medication daily, 14% had less than a seven-day supply of medication for their chronic disease.

As the population ages, the burden of chronic disease in the population increases. During a disaster with large numbers of displaced persons, accommodations for such persons must be accounted for in order to prevent a second disaster related to de-compensation of those with chronic health problems in the ACS shelter. Understanding the population needs beforehand can mitigate the effects of displacement on this population.